Page 40 - The Insurance Times June 2020

there was no deliberate intention to suppress the fact family, if any, at least 45 days before, but not earlier
or that such misstatement of or suppression of material than 60 days from the policy renewal date as per IRDAI
fact are within the knowledge of the insurer. guidelines related to portability. If such person is
presently covered and has been continuously covered
7 Cancellation without any lapses under any health insurance policy
i. The policyholder may cancel this policy by giving 15 with an Indian General/Health insurer, the proposed
days’ written notice and in such an event, the insured person will get the accrued continuity benefits
Company shall refund premium for the unexpired in waiting periods as per IRDAI guidelines on portability.
policyperiod as detailed below.
For Detailed Guidelines on portability, kindly refer the
(Note to Insurers: Insurer shall specify the link ………
method of refund calculation)
(Note to Insurers: Insurer to provide link to the
Not withstanding anything contained herein or IRDAI guidelines related to portability. Timelines for
otherwise, no refunds of premium shall be made in applying for portability may be relaxed by the insurer
respect of Cancellation where, any claim has been subject to product design)
admitted or has been lodged or any benefit has
been availed by the insured person under the policy. 10 Renewal of Policy
(Note to insurers: Insurer may relax this The policy shall ordinarily be renewable except on
condition as per the product design) grounds of fraud, misrepresentation by the insured
person.
ii. The Company may cancel the policy at any time on
i. The Company shall endeavor to give notice for
grounds of misrepresentation non-disclosure of
renewal. However, the Company is not under
material facts, fraud by the insured personby giving
15 days’ written notice. There would be no refund obligation to give any notice for renewal.
of premium on cancellation on grounds of ii. Renewal shall not be denied on the ground that the
misrepresentation, non-disclosure of material facts insured person had made a claim or claims in the
or fraud. preceding policy years.
iii. Request for renewal along with requisite premium
8 Migration shall be received by the Company before the end
The insured person will have the option to migrate the of the policy period.
policy to other health insurance products/plans offered
by the company by applying for migration of the policy iv. At the end of the policy period, the policy shall
terminate and can be renewed within the Grace
at least 30 days before the policy renewal date as per
IRDAI guidelineson Migration. If such person is presently Period of …… days (Note to insurers: Insurer to
specify grace period as per product design) to
covered and has been continuously covered without any
maintain continuity of benefits without break in
lapses under any health insurance product/plan offered
by the company,the insured person will get the accrued policy. Coverage is not available during the grace
period.
continuity benefits in waiting periods as per IRDAI
guidelines on migration. v. No loading shall apply on renewals based on
individual claims experience.
For DetailedGuidelines on migration, kindly refer the
link ………
11 Withdrawal of Policy
(Note to Insurers: Insurer to provide link to the i. In the likelihood of this product being withdrawn
IRDAI guidelineson migration.Timelines for applying in future, the Company will intimate the insured
for migration may be relaxed by the insurer subject person about the same 90 days prior to expiry of
to product design) the policy.

9 Portability ii. Insured Person will have the option to migrate to
The insured person will have the option to port the similar health insurance product available with the
policy to other insurers by applying to such insurer to Company at the time of renewal with all the
port the entire policy along with all the members of the accrued continuity benefits such as cumulative

40 The Insurance Times, June 2020